Provider First Line Business Practice Location Address:
121 SOUTH 6TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOWELLS
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68641-4067
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-986-1115
Provider Business Practice Location Address Fax Number:
402-986-1133
Provider Enumeration Date:
10/23/2006